Leadership Arlington Application for Arlington County Employees Email First Name * Last Name * Name You Prefer to be Called Gender male female Birthdate * Ethnicity Email * Address * City * State * - Select Province/State - Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon ==================== Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code * Phone Number * Have you previously applied to the Leadership Arlington Program? * Are you an LCE alum? * yes no If yes, please provide the program name and year you graduated: Employer Name * Employer Website Current Position/Title * Employer Address Employer City Employer State - Select Province/State - Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon ==================== Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming What type of organization is your employer? * Company Foundation Government Non-Profit Organization School How long have you worked at this organization? * Briefly describe your job responsibilities: * Employment History * Beginning with your most recent, please list your employment history. Education and Training * Begin with the most recent. Community commitment outside of work: * List your community involvement. This does not need to be limited to Arlington. Other activities and accomplishments * Please list other relevant accomplishments, honors, offices held and activities (including work-related). Please give an example of a situation when you felt your leadership made a difference. * 500 word limit What have you found to be your most challenging community involvement to date and why? * 500 word limit What do you believe you can offer to enhance your Leadership Arlington Class? * 500 word limit What do you hope to gain from your Leadership Arlington experience? * 500 word limit Is there anything else you’d like to share about yourself that you feel would be important for the selection committee to know during their decision-making process? * 500 word limit Please list two pressing issues facing Arlington County. Explain why they are of concern and give any ideas and suggestions that you may have for approaching and resolving these issues. * 500 word limit each Statement of Commitment: I understand the mission of Leadership Center for Excellence. If selected, I acknowledge the time commitment (including attendance at the mandatory Opening Retreat) and will pay tuition by July 17, 2020. If I am unable to comply with the requirements, I will voluntarily withdraw from the program. I understand that in the interest of the class experience for all participants, any participant may be removed from the class if, in the opinion of Leadership Center for Excellence, that participant’s conduct is not conducive to the work of the group. I further understand that tuition is not refundable in whole or in part. Signed (applicant) *
